Round 1 (Altered Mental Status)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











You are called to the resuscitation bay for a poorly responsive patient that has been brought in by EMS.











Initial Vitals











* Temp 98.8* HR 78* RR 4* BP 124/78* O2 98%











Critical Actions











* Obtain Early Blood Glucose* Administer Dextrose* Obtain Salicylate and Acetaminophen Levels* Admit for Further Observation* Psychiatry Consult











Final Diagnosis











Intentional Sulfonylurea Overdose











Tips and Tricks











All unresponsive patients should receive a blood glucose level early in the case











Additional Reading











* Sulfonylurea Toxicity Overview (LITFL)* Approach to Altered Mental Status (EM Clerkship)